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Abstract: SA-PO216

Effect on Renal Function of Repeated Administrations of Contrast Media in Cancer Patients Nephrectomized for a Metastatic Renal Cell Carcinoma: A Retrospective Italian Study

Session Information

  • Onco-Nephrology: Clinical
    November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Onco-Nephrology

  • 1500 Onco-Nephrology

Authors

  • Cosmai, Laura, San Carlo Borromeo Hospital, Milano, Italy
  • Pedone, Meri, ASST Santi Paolo e Carlo Borromeo - Ospedale San Carlo Borromeo, Milan, Italy
  • Porta, Camillo, University of Pavia, Pavia, Italy
  • Foramitti, Marina, ASST Cremona, Cremona, Italy
  • Gri, Nicole, I.R.C.C.S. Istituti Cllinici Scientifici Maugeri, Pavia, Italy
  • Gallieni, Maurizio, Ospedale San Carlo Borromeo - ASST Santi Paolo e Carlo - University of Milano, Milano, Italy
  • Cozzolino, Mario, Department of Health Sciences, University of Milan, Milan, Italy
Background

Patients with renal carcinoma (RCC) presents with concomitant chronic kidney disease (CKD) with a frequency which is about twice that of the general population; moreover, being often nephrectomised and therefore with a reduced renal functional reserve (RFR), they also present a higher incidence of acute kidney failure (AKI). Thus, we decided to evaluate the progression of renal impairment in metastatic RCC patients who underwent computed tomography (CT) scans every three months, being enrolled in experimental trials. The presence of risk factors for CKD and the possible correlation with the time elapsed between nephrectomy and the first CT scan showing the presence of metastatic disease was also evaluated

Methods

We analyzed a total of 76 patients, 59 males (78%) and 17 females (22%); 68 (89.5%) were nephrectomized for neoplasia (average age: 59.72,
standard deviation (SD): 10.51; average Body Mass Index: 26.55, SD: 4.47). The trend of renal function was evaluated on the 40 mRCC patients for which all the data investigated at the following timepoints were available: T0 (i.e. baseline), T3, T6 and T9

Results

The eGFR trend (calculated by means of the CKD-EPI formula) was substantially stable, a drop of just 2 ml/min in 9 months having been observed. Intriguing, and statistically significant (p = 0.007), was the finding of a more marked worsening of eGFR (10 ml/min in 9 months) in hypertensive patients, worsening that is not observed in the other populations of patients considered, and that it could have been caused by the
additional effect of the antiangiogenic drugs used. No correlations were found between renal function and the time elapsed between nephrectomy and the first CT scan

Conclusion

Even in nephrectomized patients, CT contrast medium appears to play a secondary role on the incidence of AKI, or on worsening of CKD. We should therefore be more liberal in the use of contrast medium, even in nephrectomized cancer patients